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Yıl:2024; Cilt: 31; Sayı: 3>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sa?ly?y Dergisi; 2024;31(3):223-229
Otizm Spektrum Bozukluğu Tanılı Ergenlerin Sosyodemografik veKlinik Profillerinin Kapsamlı İncelenmesi
Özaydın Y, Tatlı Ş, Gürbüz Özgür B, Aksu H
Ege Üniversitesi, İzmir
Amaç: Çalışmamızın amacı, polikliniğe başvuran otizm spektrum bozukluğu (OSB) tanılı ergenlerde sosyodemografik ve klinik özellikleri incelemektir. Gereç ve Yöntem: Aydın Adnan Menderes Üniversitesi Tıp Fakültesi Hastanesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Polikliniğine Temmuz 2017-Temmuz 2022 yılları arasında başvuran OSB tanılı hastaların sosyodemografik verileri ve klinik özellikleri, dosya bilgileri taranarak geriye dönük olarak incelendi. Olguların incelenen klinik özellikleri arasında hastaların OSB tanısı aldıkları yaş, otizm şiddet düzeyi, aldıkları özel eğitim süreleri, eşlik eden psikiyatrik ve fiziksel tanıları, zeka düzeyleri, psikiyatrik ilaç kullanım özellikleri, ilaç yan etkileri, ilaç kullanım nedenleri, çoklu ilaç kullanımı vardı. Bulgular: Çalışmada yer alan 118 olgunun 102’si erkekti (%86,4). Katılımcıların yaş ortalaması 14±1,8 yıldı. Hastaların klinik özellikleri incelendiğinde 42’sinde (%36,5) otizm şiddeti birinci düzeydeydi ve 43’ünde (%36,4) zihinsel yetersizlik bulunmaktaydı. En sık eşlik eden fiziksel hastalık epilepsiydi (n=30, %26,1). OSB’li ergenlerin %63,6’sına en az bir ek psikiyatrik tanı eşlik etmekteydi. En sık eşlik eden psikiyatrik tanıların dikkat eksikliği ve hiperaktivite bozukluğu, uykusuzluk bozukluğu ve obsesif kompulsif bozukluk olduğu saptandı. En sık ilaç kullanım nedeninin davranış sorunları (saldırganlık, zarar verme) olduğu saptandı. İlaç kullanım özelliklerine bakıldığında hastaların %92,4’ünde en az bir ilaç kullanım öyküsü mevcuttu. Sinirlilik ve saldırganlık (p<0,001), cinsel istek artışı (p=0,02), duygusal dalgalanma (p<0,001) semptomları olanlarda çoklu ilaç kullanımı istatistiksel olarak anlamlı daha yüksek olduğu saptandı. Sonuç: Ergenlik dönemi OSB tanılı olgularda eşlik eden psikiyatrik tanılar, zihinsel yetersizlik, epilepsi ve davranış sorunlarının sıklığı nedeni ile ilaç tedavisi ve bazı olgularda çoklu ilaç kullanımı ihtiyacı olduğu görülmektedir. İlaç tedavisi seçenekleri etki/yan etki profili göz önünde bulundurularak dikkatli bir şekilde seçilmelidir. Hastaların davranış sorunlarına yönelik davranışçı yöntemlerin yanında ilaç tedavisinin bireyselleştirilmiş bir model içinde hastaya sunulması önem arz etmektedir.
Comprehensive Examination of Sociodemographic and Clinical Profiles of Adolescents Diagnosed withAutism Spectrum Disorder
Objectives: The aim of this study was to examine the sociodemographic and clinical characteristics of adolescents with autism spectrum disorder (ASD). Materials and Methods: A retrospective analysis was conducted on patients with autism admitted to the Aydin Adnan Menderes University Faculty of Medicine Hospital Child and Adolescent Mental Health and Diseases Outpatient Clinic between July 2017 and July 2022. The relevant files were reviewed. The patients’ clinical characteristics included age at diagnosis of ASD, autism severity level, duration of special education, comorbid psychiatric and physical diagnoses, intelligence level, psychiatric medication use, side effects, indications for medication use, and polypharmacy. Results: Of the 118 patients, 102 were male (86.4%). The mean age of the participants was 14±1.8 years. When the clinical characteristics of the patients were analyzed, 42 (36.5%) patients had level 1 autism severity and 43 (36.4%) had intellectual disability. The most common comorbid physical disease was epilepsy (n=30, 26.1%). At least one additional psychiatric diagnosis in 63.6% of adolescents with ASD. The most common psychiatric diagnoses were attention deficit and hyperactivity disorder, insomnia disorder, and obsessive compulsive disorder. The most common reason for drug use was behavioral problems (aggression, harm). Regarding drug use characteristics, 92.4% of the patients had a history of at least one drug use. Multiple drug use was statistically significantly higher in patients with symptoms of irritability and aggression (p<0.001), increased sexual desire (p=0.02), and emotional lability (p<0.001). Conclusion: The need for pharmacotherapy and, in some cases, polypharmacy was observed in adolescents with ASD due to the frequency of comorbid psychiatric diagnoses, intellectual disability, epilepsy, and behavioral problems. Drug treatment options should be carefully selected considering the effect/side effect profile. It is important that pharmacotherapy is offered to the patient in an individualized model in addition to behavioral methods for behavioral problems.

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